Individual provider Active NPI

Lesley Phillips, O.T.

  • Occupational Therapist
  • Richmond, VA
National Provider Identifier
1376581462
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119002694 Issued in VA
Practice address
6314 Fredonia Rd
Richmond, VA 23227-1604
Phone
(804) 347-2749
Fax
(617) 250-8243
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119002694 VA Primary

Addresses

Primary practice location

6314 Fredonia Rd
Richmond, VA 23227-1604

Mailing address

110 Canal St Ste 3
Lowell, MA 01852-4589
Phone (888) 855-2674

Other identifiers 3

IdentifierTypeStateIssuer
OT25083OtherFLFL LICENSE
0119002694OtherVAVA LICENSE
124463OtherTXTX LICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20241008001770 VA Practitioner - Occupational Therapist in Private Practice 8224569769 Reassigns benefits to 1 organization
I20241220002493 FL Practitioner - Occupational Therapist in Private Practice 8224569769 Reassigns benefits to 1 organization
I20250122000024 TX Practitioner - Occupational Therapist in Private Practice 8224569769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Imago Rehab, IncGroup PAC ID 1850785056, 16 clinicians

Practice addresses (Care Compare)

378 Quartz Dr
Dripping Springs, TX 78620-2146
Phone (888) 855-2674

41063 W Morgan Ave
Pennington Gap, VA 24277-1831
Phone (617) 671-0789

4215 Kelson Ave
Suite C
Marianna, FL 32446-6555
Phone (888) 855-2674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124463TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Specialists of Texas PA CurrentSince Mar 21, 2025 Accepting new patients
Imago Rehab, Inc CurrentSince Jul 26, 2024 Accepting new patients

Locations

4215 Kelson Ave
Ste C
Marianna, FL 32446
Phone (617) 671-0789

110 Canal St
Ste 3
Lowell, MA 01852
Phone (617) 671-0789

500 Unicorn Park Dr
Ste 300
Woburn, MA 01801
Phone (617) 671-0789

2911 Medical Arts St
Ste 10
Austin, TX 78705
Phone (512) 474-5551

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1376581462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CANAL ST STE 3",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524589",
            "telephone_number": "888-855-2674",
            "fax_number": "617-250-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 FREDONIA RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271604",
            "telephone_number": "804-347-2749",
            "fax_number": "617-250-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "LESLEY",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "OT25083",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE",
            "identifier": "0119002694",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSURE",
            "identifier": "124463",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.